Understanding Parasomnias: When Your Brain Mixes Sleep and Wakefulness

Bysleephealth

What Are Parasomnias?

Parasomnias are fascinating but often misunderstood sleep disorders where people perform wake-like behaviors while actually being asleep. As Dr. Anne Marie Morse explains in this video, these strange sleep behaviors have become a source of social media fascination, with some people gaining fame from videos of their parasomnia experiences. However, it’s important to remember that parasomnias are real sleep-wake disorders that can significantly impact people’s lives.

Two Main Types of Parasomnias

Dr. Morse explains that parasomnias come in “two flavors”:

  1. Non-REM Parasomnias – These are more common and include:
    • Sleepwalking
    • Sleep eating
    • Night terrors (especially in children)
    • Confusional arousals (waking up confused)
    • Rarer cases of sleep driving or sleep-related sexual behavior
  2. REM Parasomnias – These include:
    • REM behavior disorder (acting out dreams)
    • Dream enactment behaviors that can be explosive or violent

Why Do Non-REM Parasomnias Happen?

Dr. Morse describes a “perfect storm” of factors that can cause non-REM parasomnias:

  • Genetic susceptibility – These conditions often run in families (Dr. Morse shares that she was a sleepwalker and sleep talker as a child, and her children have similar experiences)
  • Childhood – Children spend more time in slow-wave sleep, making parasomnias more common
  • Sleep deprivation – When we don’t get enough sleep, our brains try to “pay back” that debt with more deep sleep, increasing the chance of parasomnias
  • Other sleep disorders – Conditions like restless leg syndrome or sleep apnea can fragment deep sleep and trigger parasomnias

Understanding REM Behavior Disorder

REM behavior disorder is different from sleepwalking. People with this condition have explosive reactions to their dreams, which are often nightmares. This can result in jumping out of bed, fighting, or being combative – potentially causing injury to themselves or their bed partners.

Dr. Morse explains that REM behavior disorder can be especially concerning because:

  • In adults, it might be an early warning sign of Parkinson’s disease
  • In children, it may indicate narcolepsy
  • It can also result from withdrawal from certain medications or alcohol

When to Be Concerned

Dr. Morse suggests paying special attention to:

  • Someone who never had parasomnias before but starts experiencing them
  • Someone with a history of occasional parasomnias who suddenly experiences them more frequently

Real-Life Takeaways

  1. Not always harmless – While the common response to non-REM parasomnias like sleepwalking might be “your child will outgrow it,” Dr. Morse emphasizes that there can be underlying issues worth investigating.
  2. Sleep quality matters – Finding and addressing what’s impairing sleep quality can reduce the frequency of parasomnia episodes.
  3. Medical evaluation – Both types of parasomnias may warrant medical investigation, especially REM behavior disorder, which could signal neurological conditions.
  4. Treatment is available – Proper diagnosis can lead to treatments that improve sleep quality and overall quality of life.
  5. Family connection – If you experience parasomnias, your children might be more likely to have them too.

Understanding these unusual sleep behaviors can help reduce fear and confusion when they occur, and knowing when to seek medical help ensures that any underlying conditions are properly addressed.